MEDICARE: MRS. KELLIE KILPATRICK BATTILLO FNP-C, ARNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	APRN9179951	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1740586288
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. KELLIE KILPATRICK BATTILLO FNP-C, ARNP

Provider Business Mailing Address
First Line	:	76 S ST ANDREWS DR
Second Line	:
City	:	ORMOND BEACH
State	:	FL
Zip	:	32174-3857
Country	:	US
Telephone Number	:	321-662-6686
Fax Number	:

Provider Business Practice Location Address
First Line	:	61 MEMORIAL MEDICAL PKWY STE 3805
Second Line	:
City	:	PALM COAST
State	:	FL
Zip	:	32164-5982
Country	:	US
Telephone Number	:	386-586-1605
Fax Number	:	386-586-1607

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/01/2011
Last Update Date	:	11/18/2024

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